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 The recommendation from the Canadian Task Force on Preventive Health
Care largely mirrors U.S. recommendations regarding screenings for
speech and language delays and autism spectrum disorders.
The advice applies to children ages one to four who have no signs or
symptoms of developmental delays, said Dr. Brett Thombs, who is a
member of the Task Force.
"If parents think their child is behind on some of their important
milestones, this doesn’t apply to those kids," said Thombs, who is
affiliated with McGill University in Montreal.
Developmental delays can include, for example, problems with motor
skills, speech, language, thinking, social skills and activities of
daily life.
The Task Force writes in CMAJ that when these delays persist,
children are at higher risk of learning difficulties, behavioral
problems and functional impairments later in life.
For the new recommendation, the Task Force commissioned a review of
existing evidence to see if the benefits of screening for
developmental delays in all children ages one to four, regardless of
whether they showed signs of problems, would outweigh the potential
harms.
The screening tools are usually questionnaires that add up to a
certain number of points, said Thombs.
"Those points would determine if the physicians should act or be
more concerned," he said.
Overall two relevant randomized controlled studies were found, but
the Task Force found that the screening tools did not ultimately
improve health outcomes among children.
Instead, the screening tools had very high rates of false positives,
said Thombs.
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Those false positives would lead to many children with normal
development being referred for more testing, he added. Those
referrals may take health resources away from children who would
actually benefit from the services.
"We don’t recommend parents get their kids tested unless they have
any specific concerns," said Thombs.
In February, the U.S. Preventive Services Task Force said it did not
find enough evidence to recommend universal autism spectrum disorder
screening for toddlers between 18 and 30 months of age. Likewise, in
2015, the U.S. Task Force said there's not enough evidence to
recommend universal screening for speech and language delay and
disorders in children under age five.
"We’re not suggesting parents and physicians don’t keep ongoing
surveillance," said Thombs. "If they have any concerns at all, they
should have their physicians check it out."
SOURCE: http://bit.ly/1qf0DHx CMAJ, online March 29, 2016.
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